Arteriomanometer



Nov. 27, 1934. G B E N I 1,982,505

ARTERIOMANOMETER Filed Dec. 30, 1952 Patented Nov. 27, 1934 UNITEDSTATES PATEN OFFICE I I ARTERloMANoMETER George B. Emerson, Cambridge,Mass. Application December 30,1932, Serial No. 649,517 10 Claims. (01.rag-44x apparently because the usual manometer is primarily inthe'nature of an upperarm tourniquet and generally applied to theshallow locationof the arterial system at that area. Both upper andlower limb observationsare important where the pressure of a specificartery, such as the radial, brachial, popliteal or femoral, or wherekymographic tracings are desired. I r

' My invention contemplates also a wider basis of observation and a moreaccurate system of analysis of pressures which vary indifferent parts ofthe body.

Thus accuracy is due to thefact that both the systolic and diastolicsounds are intensified'as a result of the stronger resistance topressure of my metallic band or cufi. The special structure of themetallic band permitsa more rapid adjustment to the limb and also causesless disturbance to the subject.

V .For simplicity I refer to human anatomy but it will be understoodscientifically that the subject matter may be of any specie.

The usual manometer is essentially a tourniquet, i. e. a bandage or limpdevice adapted to be 'wound aboutthe upper arm or like member. As suchit has less inherent resistance to back pressures than a similarmetallic structure and is not adapted to accommodate and analyzecombined pressures such as those of respiration or independent muscularexpansion and contraction.

Without intent to be limited thereby, I will discuss the problem as Isee it and present my solution which for want of a better term I havereferred to generally as an arteriomanometer- This I have illustrated inthe accompanying drawing to which I shall make reference in explanationof the embodiments therein shown. In the drawing:

Fig.1 is an outer face view of such a manometer the wall or shell being;broken between its-ends to shorten the view. I y

Fig. II a fragmentary view of the inner or air bag side of thestudcarrying end of the device.

Fig. III is a transverse partial section showing the bag and stripassembly and" encasement:

connections for system as used for direct or continuous pressure underthe control of the inflation bulb. p l I Fig. V an indicated diagram ofthe system with the pressure under the control of the by-pass check.

. Fig. VIfis a sectional view of the direct andbypass systems andvalves.

Fig. VII is a sectional view showing the ad-. justable interlock of thewall strip, and

Fig. VIII 9. modified form of air and pressure connection.

, In the instrument shown I provide a band or Wall 1. This ispreferablyof spring brass say No. 30 gage, or other material capable of resisting.pressure, but flexible enough to be bent into a circular or annularform.Itis provided with adjusting holes 2 adapted to be engaged by a smallstud'hook 3. when the band is properly fastened to arm position. I i aBy making the strip 1 of proper length say twentyinches inlength andusually five inches wide, it is, adapted to use on upper limbs only,while the lowerlimbs and torso require a longer band. For torsoobservations such as at the chest, I simply provide my manometer ingreater lengthand of the samewidth. v j

On the inner face of thestrip 1 I mount an elongated rubber bag ,orbladder 4. This is preferably enclosed in a protective covering5-offabric. Over this bag supporting region of the device I draw a tubularfabric tunic 6 which holds the bag inplace and is itself held at theinner'end of the bag which extends to about the middle of the strip 1,where itis laced through a transverse series of small holes 7 by a cord8.

From this line of lacing the inner face of the band is covered by twostrips of felt which extend over the surface of the metal band exceptalong the lineof the adjusting holes 2 so that it will not come incontact with; the skin.

The bag 4 is inflated by the usual inflation bulb 9 having the usualinflation check valve 10, but provided with a release knob sothat thebag can be deflated. The bulb tube-11 is connected to the bag a beinglead through the edge of the tunic.

Connected with the air bag 4 also is the usual pressure gage 12 but inthis connection I preferably provide for a dual system of control givingincreased possibilities of observation and diagnosis. i

The tube 13 leading from the bag 4 passes out through the edge of thetunic 6 and is attached to one of the nipples of a two-way valve 14having a handle 15..

14 runs a tube 16 which is connected to a second two-way cock 17, towhich the pressure gage. Fig. IV is a diagrammatic'indication of thetube 21 is connected. The third nipples of the valves 14 and 1'7areconnected up by a by-pass From anothernipple of the casing of the valvethe bag may be entirely deflated through the tube 18. The diagnosticianis not influenced by changing registration on the dial, as the diagnosismust be made from the sounds of the pulse beat coming through thestethoscope. When the systolic sound reaches the ear the vent isinstantly closed, thereby holding the pressure in the bag. The handleson the two-Way cocks are then turned so that the pressure is directedthrough the tube 16. Such direct pressure is now registered upon thedial. Both systolic and diastolic pressures may be recorded in thismanner.

In operating the systems as shown in Figs. IV and V for a directpressure sustained by the bulb 9, the valve handles 15 and. 22 are setas in Fig. IV giving the direct connection shown in the section Fig. VI.This gives the diagnostician his usual manometric basisof appliedpressure and release on the usual scale of increase or decrease. 1 I

By my second system I-provide for'a by-pass of the pressure supply. Thecocks 14 and 17 are turned as indicated by the position of the handles15 and 22in Fig. V.

Under this system the observer has another basis of-diagnosis. Thepressure is built up and held by the check valve 19 in the by-pass 18.He is therefore able to hold at any point of pressure and even detach orremove the apparatus without losing its register;

This is in contrast with Fig. VIII which repre sents an apparatus inaccordance with my invention' connected directly in the usual manner asby the bulb tube ll to the air bag 4 and direct to the gage 12 by thetube 13 In this-case an air cook 23 is used adjacent the gage forcutting off the pressure when desired.

What I therefore claim and desire to letters Patent is:- 7 I 1. In :ablood pressure testing apparatus, a flexible strip, means for adjustablyfastening it about a member, an inflatable bag carried on the inner faceof the strip, aninflation means connected with the bag, a pressure gage,a conduit secure by connection between the gage and bag including aby-pass, a check valve in the by-paa, a positive release at the checkvalve, a two-way valve at each end of the by-p'ass whereby the gage maybe actuated direct 'or through the check-valve of r the lay-pass, and arelease at theinflation means for venting the inflation system.

Y 2. In a blood pressure testing apparatus, a flexible metal strip,means for adjustably fastening it about a member, an inflatable bagcarried "i on the inner-face of the strip, an inflation means connectedwith the bag, a pressure gage, a conduit connection between the gage andbag including a bypass, a check valve in the Soy-pass, and means forcutting the by-pass in or out whereby I the gage may be actuated director through the i on .the inner face of the strip, an inflation meansconnected with the bag, a pressure gage, a conduit connection betweenthe gage and bag including a by-pass, a check valve in theby-pass, meansfor cutting the by-pass in or out whereby I the gage may be actuateddirect or. through the check valve of the by-pass, and a release at theinflation means for venting the inflation system. 4. In a manometer fortakingblood or related body pressures, a flexible band adapted tooverlappingly encircle an included body area to be tested, means wherebysaid band may be adjusted to predetermined diameters and locked at anyselected position of adjustment about the included body area to betested, an inflatable air sac mounted on the inner face of said band, aninflation means connected with said air sac, a pressure gage, a conduitconnection between said gage and air sac including a by-pass, acheckvalve in the by-pass, and means for cutting the by-pass in or outwhereby the gage may be actuated direct or through the check-valve ofthe by-pass.

5. In a manometer apparatus for taking blood or related pressures of thebody, :a band having an air sac, said band being of resonant material ofa length suflicient to enable the band (to be overlapped upon itself andlocked about an included body area as a completely encircling memberwhich when the air sac is inflated acts both as a constrictive elementto shut off the artery and as a continuous and unbroken sound reflectivesurfacefor the systolic and diastolic sounds which may be heard when theartery is shut off, means whereby said band may be adjusted topredetermined diameters and positively locked at any selected positionof adjustment about the included body area against dislodg'menttherefrom when the air sac is inflated, and means for inflating said airsac.

'6. Apparatus as claimed in claim 5 wherein the means which permits andholds the adjustment of the band includes a fastenerat one end of theband which is selectively engageable in any of apseries of :alined holesextending from the opposite end of the band towards the center thereof.

7. Apparatus as claimed in claim 5 wherein the air sac is arranged uponthe inner face of the band and is covered by a protective covering andwherein a gauge is disposed exterlorly of the band and is adapted to beoperaztively con-v nected with the air sac'.

8. Apparatus as claimed in claim '5 wherein the inner face of the airsac is covered by a protective covering and wherein a tubular tunic isattached to said protective covering and is extended over the outer faceof the band and is attached to the band intermediate of the endsthereof.

9. Apparatus as claimed in claim 5 wherein the inner face of the air sacis covered by a protective' covering which extends along the .inner faceof the band from a point intermediate of the ends of the, band towardsone end of the band, and wherein that part of the inner face of the bandwhich is not covered by said protective covering is substantiallycovered by a separate lining member.

10. Apparatus as claimed in claim 5 wherein the inner face of the airsac is covered by a protective covering which extends "along the innerface of the band from a point intermediate of the ends of the bandtowards one end of the band,

and wherein that part of' the inner face of the band which is notcovered by said protective coveringis substantially covered by aseparate lining member there being a tubular tunic attached to saidprotective covering and. said tunic extendingover the outer face of theband and being GEORGE B. EMERSON.

